Provider Demographics
NPI:1770112344
Name:RAMOS, KELSIE JEAN (PHARM D)
Entity type:Individual
Prefix:
First Name:KELSIE
Middle Name:JEAN
Last Name:RAMOS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 DODGE ST APT 306
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1191
Mailing Address - Country:US
Mailing Address - Phone:316-706-5419
Mailing Address - Fax:
Practice Address - Street 1:1802 GALVIN RD S
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3813
Practice Address - Country:US
Practice Address - Phone:402-291-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist